Shahar Frenkel, Jacob Pe'er, Yael Deckel, Zvi Gur, Shay Kehat Ofir, Maya Eiger-Moscovich
{"title":"使用钌斑块近距离放射疗法 \"三明治技术 \"治疗结膜睑缘病变。","authors":"Shahar Frenkel, Jacob Pe'er, Yael Deckel, Zvi Gur, Shay Kehat Ofir, Maya Eiger-Moscovich","doi":"10.1016/j.jcjo.2024.07.003","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Treatment of palpebral conjunctival lesions is problematic due to late diagnosis, difficult surgical approach, and the need to preserve eyelid integrity. We describe our treatment experience using plaque brachytherapy in the \"sandwich technique.\"</p><p><strong>Design: </strong>A retrospective study.</p><p><strong>Participants: </strong>We reviewed the medical records of patients treated by plaque brachytherapy for conjunctival lesions at the Hadassah Medical Center between January 1, 2013, and January 1, 2024, and included in the analysis patients treated for palpebral conjunctival lesions.</p><p><strong>Methods: </strong>Ruthenium plaque was sutured to the palpebral conjunctiva. The matching nonradioactive \"dummy\" plaque was sutured to the external eyelid to flip the tarsal's curvature.</p><p><strong>Results: </strong>The study cohort included 5 patients, 2 men (40%) and 3 women (60%) at a median age of 68.11 years (range: 47-79.7 years). Three patients had conjunctival melanoma (60%), 1 had sebaceous carcinoma (20%), and 1 had extensive carcinoma in situ (20%). All lesions were in the left upper eyelid. Median follow-up was 37.6 months (range: 18.7-110.6 months). Four patients demonstrated a complete response (80%), while one had a partial response (20%). There was local recurrence in 1 patient (20%), and 1 patient had new foci elsewhere (20%). All patients had full local control after adding local treatments. One patient developed metastatic disease and died (20%). All patients had manageable madarosis and conjunctival scars.</p><p><strong>Conclusions: </strong>Treatment of palpebral conjunctival lesions using \"sandwich\" plaque brachytherapy is safe and effective. To the best of our knowledge, this treatment was never described before, and we believe it should be added to our armamentarium.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3000,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Treatment of conjunctival palpebral lesions using ruthenium plaque brachytherapy \\\"sandwich technique\\\".\",\"authors\":\"Shahar Frenkel, Jacob Pe'er, Yael Deckel, Zvi Gur, Shay Kehat Ofir, Maya Eiger-Moscovich\",\"doi\":\"10.1016/j.jcjo.2024.07.003\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Treatment of palpebral conjunctival lesions is problematic due to late diagnosis, difficult surgical approach, and the need to preserve eyelid integrity. We describe our treatment experience using plaque brachytherapy in the \\\"sandwich technique.\\\"</p><p><strong>Design: </strong>A retrospective study.</p><p><strong>Participants: </strong>We reviewed the medical records of patients treated by plaque brachytherapy for conjunctival lesions at the Hadassah Medical Center between January 1, 2013, and January 1, 2024, and included in the analysis patients treated for palpebral conjunctival lesions.</p><p><strong>Methods: </strong>Ruthenium plaque was sutured to the palpebral conjunctiva. The matching nonradioactive \\\"dummy\\\" plaque was sutured to the external eyelid to flip the tarsal's curvature.</p><p><strong>Results: </strong>The study cohort included 5 patients, 2 men (40%) and 3 women (60%) at a median age of 68.11 years (range: 47-79.7 years). Three patients had conjunctival melanoma (60%), 1 had sebaceous carcinoma (20%), and 1 had extensive carcinoma in situ (20%). All lesions were in the left upper eyelid. Median follow-up was 37.6 months (range: 18.7-110.6 months). Four patients demonstrated a complete response (80%), while one had a partial response (20%). There was local recurrence in 1 patient (20%), and 1 patient had new foci elsewhere (20%). All patients had full local control after adding local treatments. One patient developed metastatic disease and died (20%). All patients had manageable madarosis and conjunctival scars.</p><p><strong>Conclusions: </strong>Treatment of palpebral conjunctival lesions using \\\"sandwich\\\" plaque brachytherapy is safe and effective. To the best of our knowledge, this treatment was never described before, and we believe it should be added to our armamentarium.</p>\",\"PeriodicalId\":9606,\"journal\":{\"name\":\"Canadian journal of ophthalmology. 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Treatment of conjunctival palpebral lesions using ruthenium plaque brachytherapy "sandwich technique".
Objective: Treatment of palpebral conjunctival lesions is problematic due to late diagnosis, difficult surgical approach, and the need to preserve eyelid integrity. We describe our treatment experience using plaque brachytherapy in the "sandwich technique."
Design: A retrospective study.
Participants: We reviewed the medical records of patients treated by plaque brachytherapy for conjunctival lesions at the Hadassah Medical Center between January 1, 2013, and January 1, 2024, and included in the analysis patients treated for palpebral conjunctival lesions.
Methods: Ruthenium plaque was sutured to the palpebral conjunctiva. The matching nonradioactive "dummy" plaque was sutured to the external eyelid to flip the tarsal's curvature.
Results: The study cohort included 5 patients, 2 men (40%) and 3 women (60%) at a median age of 68.11 years (range: 47-79.7 years). Three patients had conjunctival melanoma (60%), 1 had sebaceous carcinoma (20%), and 1 had extensive carcinoma in situ (20%). All lesions were in the left upper eyelid. Median follow-up was 37.6 months (range: 18.7-110.6 months). Four patients demonstrated a complete response (80%), while one had a partial response (20%). There was local recurrence in 1 patient (20%), and 1 patient had new foci elsewhere (20%). All patients had full local control after adding local treatments. One patient developed metastatic disease and died (20%). All patients had manageable madarosis and conjunctival scars.
Conclusions: Treatment of palpebral conjunctival lesions using "sandwich" plaque brachytherapy is safe and effective. To the best of our knowledge, this treatment was never described before, and we believe it should be added to our armamentarium.
期刊介绍:
Official journal of the Canadian Ophthalmological Society.
The Canadian Journal of Ophthalmology (CJO) is the official journal of the Canadian Ophthalmological Society and is committed to timely publication of original, peer-reviewed ophthalmology and vision science articles.